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P-4.87 Brain death donation improvement areas: Procurement impact

Olga E Facio, Mexico

First year resident of surgical and medical emergencies
Emergency
Hospital General Dr. Gaudencio Gonzalez Garza Centro Médico Nacional La Raza.

Recommended Reading Websites

CENATRA

Abstract

Brain death donation improvement areas: Procurement impact

Olga Estefanía Olvera 1, María del Pilar Domínguez 3, Bertha A. García 2, Carlos Ocampo 2.

1Emergency department , Hospital General Dr. Gaudencio Gonzalez Garza Centro Médico Nacional La Raza , Mexico City , , Mexico; 2Coordinación de donación de órganos y tejidos con fines de trasplante , Hospital de Especialidades Dr. Antonio Fraga Mouret Centro Médico Nacional La Raza, Mexico City , , Mexico; 3Departamento de Investigación y educación en salud, Hospital de Especialidades Dr. Antonio Fraga Mouret Centro Médico Nacional La Raza , Mexico City , , Mexico

Introduction: in Mexico, there are 23,158 patients registered in the national organ and tissue transplant waiting list. The procurement of grafts from expanded criteria donors is justified by the increasing demand, however, not even all standard grafts have been procured. The objective was to identify the associated factors to decision making of whether to procure, or not, grafts from brain death (BD) donors in whom multiorganic donation was consented.
Methods: retrospective cohort, univariate and multivariate analysis. 35 donation files with BD were included from 2014 to 2019. Two groups were compared, the donors in which the heart wasn´t procured versus those that was procured, same comparisons were done for liver, kidney, skin, bone tissue and corneas.





Results: 20 women (57.1%), 15 men (42.9%) average age of 43.8 ± 16.4 years.  High-dose of inotropic or norepinephrine use favored cardiac procurement OR 0.57 (CI 0.0-0.5). None sensitive and specific variable was detected for decision making at liver procurement.



Implementation of two or more diagnostic methods for BD were associated with kidney loss OR 10 (CI 1.2-78.1). Dyslipidemia was an associated factor for non-procurement of skin and bone tissue OR 32 (CI 1.05-970.8) and family disagreement with health care institution for cornea OR 4 (CI 2.1-7.2). 183 (74.6%) organs and tissues met standard criteria, however 76 (41.5%) were not procured.

Conclusions: Non-procurement associated factors were different from the standard donor established criteria. An opportunity area is to follow clear procurement criteria in order to reduce viable grafts loss.

References:

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Presentations by Olga E Facio

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